Term
| when do you give abx for acute bronchitis? |
|
Definition
| only if elderly, underlying cardiopulm ds, persistent cough (>7-10 days) or immunocompromised |
|
|
Term
acute bronchitis tx if influenza w/in how long?
tx? |
|
Definition
48 hours*
A - Amantadine, Rimantadine
A or B - Oseltamivir (Tamiflu), Zanamivir |
|
|
Term
| chronic bronchitis microbiology |
|
Definition
| 45% are colonized with Haemophilus influenza, 20% strep pneumoniae, 30% M. catarrhalis |
|
|
Term
| chronic bronchitis: persistent cough usually productive (clear to yellow) is called ____ |
|
Definition
|
|
Term
| acute exacerbations of CHRONIC bronchitis tx: do not give ____ |
|
Definition
| no mucolytics or cough suppressants |
|
|
Term
|
Definition
|
|
Term
| what is the 7th MC COD from an infectious ds in the US? |
|
Definition
|
|
Term
| what is the 2nd most common hospital acquired infection? |
|
Definition
|
|
Term
|
Definition
(-mycin)
Azithromycin
Clarithromycin |
|
|
Term
| age 1 -3 months for CAP tx |
|
Definition
|
|
Term
|
Definition
inactivated influenza vaccine (>50 yo)
live influenza vaccine (2-49 yo) |
|
|
Term
| most common hospital acquired pneumonia |
|
Definition
Pseudomonas aeruginosa
klebsiella pneumona
Enterobacter
Staphylococcus aureus |
|
|
Term
| hospital acquired pneumonia - what is not a good marker for improvement |
|
Definition
|
|
Term
|
Definition
| chronic inflammatory ds with airway hyper responsiveness, airflow obstruction and airway inflammation |
|
|
Term
|
Definition
| reverse airflow obstruction RAPIDLY |
|
|
Term
| asthma - when you are a step ___ or higher, consult an asthma specialist |
|
Definition
|
|
Term
| what type of agonists are not used due to cardiac effects? |
|
Definition
| non specific agonists (we use beta 2 agonists) |
|
|
Term
| ____ a long acting anticholinergic for asthma, onset 5 MINUTES |
|
Definition
|
|
Term
| asthma tx: ____ absorption and clearance HIGH VARIABLE, monitor |
|
Definition
|
|
Term
|
Definition
cigarette smoking!!!
(also genetics, environment pollutants, lung growth) |
|
|
Term
|
Definition
midlife (vs asthma, early in childhood)
slowly progressive (asthma varies)
long smoking or exposure to smoking (asthma - allergy, rhinitis, eczema) |
|
|
Term
which is irreversible?
COPD or asthma? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| management of COPD - stage 1 |
|
Definition
| get a flu vaccine and SABA when needed (same as asthma!) |
|
|
Term
| stage 2 management of COPD |
|
Definition
| uses long acting - LABA (stage 1 uses short acting) |
|
|
Term
COPD medications
SABA
LABA
ICS |
|
Definition
Albuterol
Salmeterol
Beclomethasone |
|
|
Term
|
Definition
walk across room
SABA use < every 4 hrs |
|
|
Term
| where is the first pass for an asthma inhaler? |
|
Definition
|
|
Term
| what is important when it comes to antimicrobial therapy for sepsis? |
|
Definition
promt abx therapy after the onset of hypotension is critical
(****many stars and in red!) |
|
|
Term
antihistamines for pulm ds
- sedating
- non sedating
- both are selective for what? |
|
Definition
- highly lipophilic
- large, protein bound, lipophobic charged side chains
- histmane 1 receptor |
|
|
Term
| antihistamine drug interaction |
|
Definition
CNS depressants have additive effects (alcohol, sedatives, narcotics)
MAOIs increase anticholinergic and CNS depressive effects (hypotension w/dexchlorpheniramine, phenelzine, tranylcypromine) |
|
|
Term
| 2nd generation antihistamine, least sedating |
|
Definition
allegra
(zyrtec causes sedation) |
|
|
Term
| when you do avoid oral decongestants? |
|
Definition
in people with HTN (unless absolutely necessary)
(examples: pseudoephedrine, phenylephrine) |
|
|
Term
what stimulates sweating in the sweat chloride test?
what is the control? |
|
Definition
- pilocarpine
placed under electrode pad
- saline under other electrode pad on arm |
|
|
Term
| what is the most chronic ds in children? |
|
Definition
|
|
Term
| what is the most chronic ds in children? |
|
Definition
|
|
Term
| what type of immunity works immediately? |
|
Definition
|
|
Term
| what is the advantage to conjugated polysaccharide vaccines? |
|
Definition
| increased immunogenicity in infants (t cell response) |
|
|
Term
| what vaccine was thought to give autism? |
|
Definition
|
|
Term
| ______ vaccine may give better results |
|
Definition
|
|
Term
| ______ vaccines will need boosters most of the time |
|
Definition
|
|
Term
| what is an example of a live virus that may need a booster? |
|
Definition
|
|
Term
| what is important in regards to immunizations and when to give them? |
|
Definition
|
|
Term
| are there any contraindications to simultaneous administration of any routinely administered injectable vaccine? |
|
Definition
|
|
Term
| what is the spacing required for 2 live vaccines if not simultaneous? |
|
Definition
| 4 week minimum interval (ex MMR, varicella) |
|
|
Term
when should you never use a live vaccine?
examples? |
|
Definition
pregancy
MMR, varicela, zoster |
|
|
Term
| is over immunization a problem? |
|
Definition
|
|
Term
| do not immunize before ___ weeks of age, except _____ vaccine |
|
Definition
|
|
Term
| is Flumist inactivated or live? |
|
Definition
live
dont give to pregnant women |
|
|
Term
| when do you give the tetanus immunoglobulin? |
|
Definition
| passive immunity following traumatic wounds in unimmunized or under immunized pts |
|
|
Term
| post exposure prophylaxis is effective within ___ hours of measles exposure |
|
Definition
|
|
Term
| most common sexually transmitted virus |
|
Definition
|
|
Term
when is a baby given the Hep B vaccine?
how many doses are needed in your life? |
|
Definition
before hospital discharge
3 |
|
|
Term
what is the most common vaccine you will see?
can it cause ds? |
|
Definition
|
|
Term
| __ % of pts progress from latent TB infection to reactivation or active ds |
|
Definition
|
|
Term
| what can give a false + w/the TB test? |
|
Definition
| BCG vaccine (not recommended in US bc low efficacy) |
|
|
Term
| prophylactic TB therapy and pregnant women |
|
Definition
| not given preventative therapy until AFTER DELIVERY, unless they have certain medical conditions |
|
|
